Effect of orthodontic treatment on alveolar bone thickness in adults: a systematic review

Only prospective clinical studies that reported bone thickness in adult patients undergoing non-surgical orthodontic treatment were considered eligible. MEDLINE, EMBASE and LILACS databases were searched for articles published up to July 2018.

Results:

A total of 12 studies met the selected criteria. Most of the studies showed that orthodontic treatment produces a reduction in bone thickness of incisors, mainly at the palatal side.

Conclusion:

On patients undergoing different orthodontic treatment techniques, there was a significant bone thickness reduction, mainly on the palatal side.

Clinical relevance:

These findings are relevant and have to be considered in diagnosis and planning of tooth movement, in order to prevent the occurrence of dehiscence and fenestration in alveolar bone.

Keywords:
Orthodontics; Alveolar bone loss; Periodontics; Tooth movement

Authorship

Michelle Sendyk

Universidade de São Paulo, Departamento de Ortodontia e Odontopediatria, Divisão de Ortodontia (São Paulo/SP, Brazil).Universidade de São PauloBrazilSão Paulo, SP, BrazilUniversidade de São Paulo, Departamento de Ortodontia e Odontopediatria, Divisão de Ortodontia (São Paulo/SP, Brazil).

http://orcid.org/0000-0001-9850-8790

Daniele Sigal Linhares

http://orcid.org/0000-0003-1979-1343

Claudio Mendes Pannuti

Universidade de São Paulo, Departamento de Estomatologia, Divisão de Periodontia (São Paulo/SP, Brazil).Universidade de São PauloBrazilSão Paulo, SP, BrazilUniversidade de São Paulo, Departamento de Estomatologia, Divisão de Periodontia (São Paulo/SP, Brazil).

http://orcid.org/0000-0003-4181-3975

João Batista de Paiva

http://orcid.org/0000-0002-3178-4843

José Rino Neto

http://orcid.org/0000-0002-9124-8698

Contact address:
Michelle Sendyk Universidade de São Paulo, Departamento de Ortodontia Av. Professor Lineu Prestes, 2227, Cidade Universitária E-mail: msendyk@usp.br- São Paulo/SP - CEP: 05.508-000 - Brazil

Conception or design of the study: MS, CMP. Data acquisition, analysis or interpretation: MS, DSL, CMP, CMP, JBP, JRN. Writing the article: MS. Critical revision of the article: MS, DSL, CMP, CMP, JBP, JRN. Final approval of the article: MS, DSL, CMP, CMP, JBP, JRN. Overall responsibility: MS.

»
The authors report no commercial, proprietary or financial interest in the products or companies described in this article.

SCIMAGO INSTITUTIONS RANKINGS

Figures | Tables

Figures (2)
Tables (3)

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Figure 1
PRISMA diagram of article retrieval.

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Figure 2
Risk of bias summary.

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Table 1
Characteristics of the studies.

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Table 2
Methodological quality evaluation of included studies using Newcastle-Ottawa scale.

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Table 3
Individual studies outcomes.

Figure 1 PRISMA diagram of article retrieval.

Figure 2 Risk of bias summary.

Table 1 Characteristics of the studies.

Study	Country	Study design	Follow-up	Sample size (baseline)	CBCT Specifications	Source of funding
Ahn et al.³¹31 Ahn HW, Moon SC, Baek SH. Morphometric evaluation of changes in the alveolar bone and roots of the maxillary anterior teeth before and after en masse retraction using cone-beam computed tomography. Angle Orthod. 2013 Mar;83(2):212-21., 2013	South Korea	Case series	Not reported	n = 37 female Age range: 26.6 ± 8.5 years	Implagraphy, 12x9-cm field of view, 90-kVp, 4.0-mA tube current, 0.2-mm voxel size and 24-second scan time	No
Almeida et al.²⁶26 Almeida MR, Futagami C, Conti AC, Oltramari-Navarro PV, Navarro RL. Dentoalveolar mandibular changes with self-ligating versus conventional bracket systems: A CBCT and dental cast study. Dental Press J Orthod. 2015 May-June;20(3):50-7, 2015	Brazil	RCT	Not reported	n= 25 (sex distribution not mentioned) Age mean (years): 18.58 ± 5.43 (test); 21.61 ± 6.69 (control)	i-CAT Imaging Sciences International, 22x16-cm field of view, 120 kVp, 36 mA, 0.4-mm voxel size and 40-second scan time	No
Cattaneo et al.²⁷27 Cattaneo PM, Treccani M, Carlsson K, Thorgeirsson T, Myrda A, Cevidanes LH, et al. Transversal maxillary dento-alveolar changes in patients treated with active and passive self-ligating brackets: a randomized clinical trial using CBCT-scans and digital models. Orthod Craniofac Res. 2011 Nov;14(4):222-33., 2011	Denmark	Parallel RCT	Not reported	n= 64 (sex distribution not mentioned) Age mean (years): 16.0 ± 5.7 (test); 15.0 ± 3.3 (control)	NewTom 3G, 12 in field of view, 0.36-mm voxel size	CMF Software (M.E. Muller Institute for Surgical Technology and Biomechanics, University of Bern, Switzerland, developed under the funding of the CO-ME Network)
Lombardo et al.²⁸28 Lombardo L, Bragazzi R, Perissinotto C, Mirabella D, Siciliani G. Cone-beam computed tomography evaluation of periodontal and bone support loss in extraction cases. Prog Orthod. 2013 Sept 11;14:29., 2013	Italy	Controlled clinical trial	Not reported	n= 22 (10 male and 12 female) Age mean (years): 11.9 (test); 10.11 (control)	NewTom 3G, 12 in field of view, 110- kV, 2.00 mA, 5.4 second exposure time	No
Nayak-Krishna et al.³²32 Nayak Krishna US, Shetty A, Girija MP, Nayak R. Changes in alveolar bone thickness due to retraction of anterior teeth during orthodontic treatment: a cephalometric and computed tomography comparative study. Indian J Dent Res. 2013;24(6):736-41., 2013	India	Case series	Not reported	n= 10 (sex distribution not mentioned) Age range: 15 ± 3 years	GE medical systems, 120 kV, 160 mva	No
Oliveira et al.³⁷37 Oliveira TMF, Claudino LV, Mattos CT, Sant'Anna EF. Maxillary dentoalveolar assessment following retraction of maxillary incisors: a preliminary study. Dental Press J Orthod. 2016 Sept-Oct;21(5):82-9., 2016	Brazil	Case series	Not reported	n= 11 (5 male and 6 female) Age range: 18 to 26 years old	i-CAT Imaging Sciences International, 13x17-cm field of view, 120 kVp, 5 mA, 0.4-mm voxel size and 20-second scan time	No
Picanço et al.²⁹29 Picanço PR, Valarelli FP, Cançado RH, Freitas KM, Picanço GV. Comparison of the changes of alveolar bone thickness in maxillary incisor area in extraction and non-extraction cases: computerized tomography evaluation. Dental Press J Orthod. 2013 Sept-Oct;18(5):91-8., 2013	Brazil	Controlled clinical trial	Not reported	n= 12 (10 male and 2 female) Age mean: 15.83 ± 4.87 years (test); 18.26 ± 6.42 years (control)	Not reported	No
Sarikaya et al.³³33 Sarikaya S, Haydar B, Ciger S, Ariyürek M. Changes in alveolar bone thickness due to retraction of anterior teeth. Am J Orthod Dentofacial Orthop. 2002 July;122(1):15-26., 2002	Turkey	Case series	Not reported	n = 19 (sex distribution not mentioned) Age mean: 14.1 ± 2.3 years	Tomoscan SR7000, 120 kV, 175 mA and 1.5-mm slice thickness	No
Sun et al.³⁰30 Sun B, Tang J, Xiao P, Ding Y. Presurgical orthodontic decompensation alters alveolar bone condition around mandibular incisors in adults with skeletal Class III malocclusion. Int J Clin Exp Med. 2015;8(8):12866-73., 2015	China	Controlled clinical trial	Not reported	n= 42 (sex distribution not mentioned) Age mean: not mentioned	Galileo, 150-mmx150-mm field of view, 85 kV, 21 mA, 20 second exposure time	This work was supported by the School Funds of Jinling Hospital, School of Medicine, Nanjing University (No. 2013079). Open Science Foundation for National Key Laboratory of Military Stomatology (No. 2014KC02), and China Postdoctoral Science Foundation (No. 2015M572814)
Thongudomporn et al.³⁴34 Thongudomporn U, Charoemratrote C, Jearapongpakorn S. Changes of anterior maxillary alveolar bone thickness following incisor proclination and extrusion. Angle Orthod. 2015 July;85(4):549-54., 2015	Thailand	Case series	Not reported	n = 15 (4 male and 11 female) Age mean: 9.9 ± 1.0 years	Veraviewepocs J Morita MPG, 80 kV, 5 mA, 7.5 second exposure time, 0.125 mm voxel resolution, 80 x 40 mm field of view	Grant support from Graduate School and the Faculty of Dentistry, Prince of Songkla University
Uribe et al.³⁵35 Uribe F, Padala S, Allareddy V, Nanda R. Cone-beam computed tomography evaluation of alveolar ridge width and height changes after orthodontic space opening in patients with congenitally missing maxillary lateral incisors. Am J Orthod Dentofacial Orthop. 2013 Dec;144(6):848-59., 2013	USA	Case series	Not reported	n = 11 (7 male and 4 Female) Age range: 16.45 ± 5.76 years	i-CAT Classic scanner, 20-second scan time with a 16-cm x 13-cm field of view at a resolution of 0.3-mm voxels, 120 kVp, 3-8 mA	No
Yodthong et al.³⁶36 Yodthong N, Charoemratrote C, Leethanakul C. Factors related to alveolar bone thickness during upper incisor retraction. Angle Orthod. 2013 May;83(3):394-401., 2013	Thailand	Case series	Not reported	n = 23 (2 Male and 21 Female) Age range: 20.4 ± 2.7 years	Veraviewepocs J Morita MPG, 80 kV, 5 mA, 7.5 second exposure time, 0.125 mm voxel resolution, 80 x 40 mm field of view	Graduate School, Faculty of Dentistry, Prince of Songkla University, for grant support

Table 2 Methodological quality evaluation of included studies using Newcastle-Ottawa scale.

Study		Ahn et al.³¹31 Ahn HW, Moon SC, Baek SH. Morphometric evaluation of changes in the alveolar bone and roots of the maxillary anterior teeth before and after en masse retraction using cone-beam computed tomography. Angle Orthod. 2013 Mar;83(2):212-21.	Nayak-Krishna et al.³²32 Nayak Krishna US, Shetty A, Girija MP, Nayak R. Changes in alveolar bone thickness due to retraction of anterior teeth during orthodontic treatment: a cephalometric and computed tomography comparative study. Indian J Dent Res. 2013;24(6):736-41.	Oliveira et al.³⁷37 Oliveira TMF, Claudino LV, Mattos CT, Sant'Anna EF. Maxillary dentoalveolar assessment following retraction of maxillary incisors: a preliminary study. Dental Press J Orthod. 2016 Sept-Oct;21(5):82-9.	Sarikaya et al.³³33 Sarikaya S, Haydar B, Ciger S, Ariyürek M. Changes in alveolar bone thickness due to retraction of anterior teeth. Am J Orthod Dentofacial Orthop. 2002 July;122(1):15-26.	Thongudomporn et al.³⁴34 Thongudomporn U, Charoemratrote C, Jearapongpakorn S. Changes of anterior maxillary alveolar bone thickness following incisor proclination and extrusion. Angle Orthod. 2015 July;85(4):549-54.	Uribe et al.³⁵35 Uribe F, Padala S, Allareddy V, Nanda R. Cone-beam computed tomography evaluation of alveolar ridge width and height changes after orthodontic space opening in patients with congenitally missing maxillary lateral incisors. Am J Orthod Dentofacial Orthop. 2013 Dec;144(6):848-59.	Yodthong et al.³⁶36 Yodthong N, Charoemratrote C, Leethanakul C. Factors related to alveolar bone thickness during upper incisor retraction. Angle Orthod. 2013 May;83(3):394-401.
Selection	Sample size calculation	0	0	*	0	*	0	0
	Representativeness of orthodontic patients	*	*	0	*	*	0	0
	Selection of the orthodontic control group	0	0	0	0	0	0	0
	Ascertainment of the bone before orthodontic treatment	*	*	*	*	*	*	*
	Outcome of interest not present at the start	0	*	0	0	0	0	*
	Training of assessors	0	0	0	0	0	0	0
	Description of inclusion/exclusion criteria	*	*	*	0	*	*	*
Comparability	Comparability of groups on the basis of the design	0	0	0	0	0	0	0
Comparability	Management of confounders	*	*	*	0	0	*	*
Outcome	Assessment of clinical conditions	0	0	0	0	0	0	0
	Definitions and assessment of bone resorption clearly reported	*	*	*	0	*	*	*
	Adequacy of follow-up of patients	0	0	0	0	0	0	0
Statistics	Validity of statistical analysis	*	*	*	*	*	*	*
Statistics	Unit of analysis reported	*	0	0	0	0	*	0
Total	(14/14)	7/14	7/14	6/14	3/14	6/14	6/14	6/14

Table 3 Individual studies outcomes.

Articles	Teeth	Groups	Views	Results*
Ahn et al.³¹, 2013	Maxillary central incisors Maxillary lateral incisors Maxillary canines	Test group (Class I dentoalveolar protrusion treated with extraction of the four first premolars and sliding mechanics and straight-wire appliance)	Buccal side Palatal side	CENTRAL INCISORS Buccal: Cervical: -0.16 ± 1.89 mm / Middle: 0.65 ± 1.47 mm / Apical: -0.19 ± 2.42 mm Palatal: Cervical: -1.82 ± 1.18 mm / Middle: -4.32 ± 3.09 mm / Apical: -6.66 ± 6.62 mm LATERAL INCISORS Buccal: Cervical: 0.05 ± 0.98 mm / Middle: 0.84 ± 1.49 mm / Apical: 0.09 ± 1.62 mm Palatal: Cervical: -1.40 ± 0.94 mm / Middle: -3.38 ± 3.30 mm / Apical: -6.17 ± 6.27 mm CANINES Buccal: Cervical: 0.64 ± 2.67 mm / Middle: 0.40 ± 1.82 mm / Apical: -0.10 ± 3.73 mm Palatal: Cervical: -1.57 ± 2.11 mm / Middle: -2.29 ± 6.44 mm / Apical: -8.25 ± 13.51 mm
Almeida et al.²⁶, 2015	Mandibular first premolar Mandibular second premolar Mandibular first molar	Test group (Class I malocclusion treated with self-ligated brackets) Control group (Class I malocclusion treated with conventional brackets)	Buccal side at apical height	Test Group First premolar: -0.77 ± 1.46 mm / Second premolar: -0.86 ± 0.72 mm First molar: -0.43 ± 0.76 mm Control Group First premolar: -1.20 ± 1.64 mm / Second premolar: -0.98 ± 1.78 mm / First molar: -0.55 ± 0.91 mm
Cattaneo et al.²⁷, 2011	First premolar	Test group (Damon passive self-ligated brackets) Control group (In-Ovation active self-ligated brackets)	Buccal cortical bone plate	Damon T₁ - T₀(n=32) Upper premolar: -0.1 ± 3.27 mm In-Ovation T₁-T₀(n=32) Upper premolar: -2.25 ± 3.20 mm
Lombardo et al.²⁸, 2013	Mandibular first premolar Maxillary second premolar	Test group (Class II division 1 malocclusion with extraction of the upper first premolars and lower second premolars treated with Tweed technique) Control group (orthodontic treatment without extraction with Tweed technique)	Buccolingual thickness (BT)	Test group First premolar BT changes: 3.19 mm Second premolar BT changes: 1.71 mm Control group First premolar BT changes: 0.98 mm Second premolar BT changes: 0.67 mm
Nayak-Krishna et al.³², 2013	Maxillary central incisors Maxillary lateral incisors Mandibular central incisors Mandibular lateral incisors	Test group (patients with bimaxillary dentoalveolar protrusion treated with extraction of first premolars and edgewise technique)	3 mm 6 mm 9 mm Buccal bone thickness (BBT) Lingual bone thickness (LBT)	Maxillary central incisors BBT: 3 mm: 0.30 ± 0.5 mm / 6 mm: 0.20 ± 0.44 mm / 9 mm: 0.10 ± 0.76 mm Maxillary central incisors LBT: 3 mm: 0.40 ± 0.77 mm / 6 mm: 0.50 ± 0.54 mm / 9 mm: -0.40 ± 0.54 mm Maxillary lateral incisors BBT: 3 mm: 0.40 ± 0.5 mm / 6 mm: 0.30 ± 0.5 mm / 9 mm: 0.50 ± 0.77 mm Maxillary lateral incisors LBT: 3 mm: 0.10 ± 0.61 mm / 6 mm: 0.40 ± 0.5 mm / 9 mm: 0.40 ± 0.76 mm Mandibular lateral incisors BBT: 3 mm: 0.10 ± 0.42 mm / 6 mm: 0.30 ± 0.45 mm / 9 mm: 0.30 ± 0.72 mm Mandibular lateral incisors LBT: 3 mm: 0.40 ± 0.97 mm / 6 mm: -0.30 ± 0.80 mm / 9 mm: -0.50 ± 0.51 mm Mandibular central incisors BBT: 3 mm: 0.30 ± 0.46 mm / 6 mm: 0.40 ± 0.51 mm / 9 mm: 0.30 ± 0.74 mm Mandibular central incisors LBT: 3 mm: 0.40 ± 0.51 mm / 6 mm: -0.30 ± 0.46 mm / 9 mm: -0.60 ± 0.51 mm
Articles	Teeth	Groups	Views	Results*
Oliveira et al.³⁷, 2016	Maxillary central and lateral incisors	Test group (Class II division 1 and Class I malocclusion treated with extraction of first premolars and edgewise technique)	Alveolar bone width measurements at 2, 4, 6, 8, 10, 12 and 14 mm apical to the alveolar crest	Bone width at 2 mm: RD: -1.11 ± 0.61 / RM: -0.9 ± 0.13 mm / ML: 0.22 ± 1.11 mm / LM: -0.8 ± 0.13 mm / LD: -1.12 ± 0.63 mm Bone width at 4 mm: RD: -0.99 ± 0.67 mm / RM: -0.77 ± 0.61 mm / ML: 0.49 ± 1.3 mm / LM: -0.81 ± 0.36 mm / LD: -0.61 ± 0.18 mm Bone width at 6 mm: RD: -0.06 ± 0.86 mm / RM: 0 ± 0.32 mm / ML: 0.33 ± 0.29 mm LM: -0.63 ± 0.06 mm / LD: 0.01 ± 0.27 mm Bone width at 8 mm: RD: -0.06 ± 0.49 mm / RM: 0.18 ± 0.65 mm / ML: 0.22 ± 0.51 mm LM: -0.23 ± 0.16 mm / LD: 0.02 ± 0.03 mm Bone width at 10 mm: RD: 0.47 ± 0.65 mm / RM: 0.39 ± 0.43 mm / ML: 0.22 ± 0.41 mm LM: 0.38 ± 0.11 mm / LD: 0.42 ± 0.41 mm Bone width at 12 mm: RD: 0.04 ± 0.13 mm / RM: 0.56 ± 0.96 mm / ML: 0.46 mm ± 0.91 LM: 0.39 ± 0.48 mm / LD: 0.08 ± 0.24 mm Bone width at 14 mm: RD: -0.58 ± 4.38 mm / RM: -1.19 ± 4.66 mm / ML: -1.33 ± 2.68 mm LM: -1.11 ± 4.62 mm / LD: 0.72 ± 0.08 mm
Picanço et al.²⁹, 2013	Maxillary central incisors	Test group (Class II malocclusion treated with upper premolar extraction) Control group (Class I and Class II malocclusion treated without extraction)	Buccal and palatal sides at 3 mm, 6 mm and 9 mm from cemento-enamel junction UL: Buccal alveolar bone UP: Palatal alveolar bone	Group 1 (n=6): UL cerv.: 0.63 ± 0.49 mm / UP cerv.: -1.39 ± 0.51 mm / UL midpoint: 1.15 ± 1.27 mm / UP midpoint: -1.62 ± 0.86 mm / UL apical: 1.95 ± 2.98 mm / UP apical: -1.54 ± 2.57 mm Group 2 (n=6): UL cerv.: -0.06 ± 0.47 mm / UP cerv.: -0.66 ± 0.90 mm / UL midpoint: 0.16 ± 0.86 mm / UP midpoint: -0.80 ± 0.76 mm / UL apical: 0.00 ± 0.74 / UP apical: -0.56 ± 1.51 mm
Sarikaya et al.³³, 2002	Maxillary central incisors Maxillary lateral incisors Mandibular central incisors Mandibular lateral incisors	Test group (patients with dentoalveolar bimaxillary protrusion treated with extractions of the 4 first premolars and straight-wire appliances)	Buccal and palatal sides at 3 mm, 6 mm and 9 mm from cemento-enamel junction	LABIAL Maxillary central incisors 3 mm: -0.24 ± 0.57 mm / 6 mm: -0.03 ± 0.64 mm / 9 mm: 0.06 ± 0.89 mm Maxillary lateral incisors 3 mm: -0.26 ± 0.53 mm / 6 mm: 0.20 ± 0.50 mm / 9 mm: 0.19 ± 0.64 mm LINGUAL Maxillary central incisors 3 mm: -0.93 ± 0.69 mm / 6 mm: -1.12 ± 0.06 mm / 9 mm: -0.58 ± 1.33 mm Maxillary lateral incisors 3 mm: -1.11 ± 0.58 mm / 6 mm: -0.97 ± 0.91 mm / 9 mm: -0.67 ± 1.48 mm LABIAL Mandibular central incisors: 3 mm: -0.28 ± 0.44 mm / 6 mm: -0.05 ± 0.68 mm / 9 mm: -0.28 ± 1.04 mm Mandibular lateral incisors: 3 mm: -0.38 ± 0.28 mm / 6 mm: -0.22 ± 0.52 mm / 9 mm: -0.30 ± 0.89 mm LINGUAL Mandibular central incisors: 3 mm: -0.87 ± 0.41 mm / 6 mm: -0.52 ± 0.75 mm / 9 mm: -0.46 ± 0.13 mm Mandibular lateral incisors: 3 mm: -0.66 ± 0.5 mm / 6 mm: -0.49 ± 0.78 mm / 9 mm: -0.22 ± 0.97 mm
Sun et al.³⁰, 2015	Mandibular incisors	Test group (patients with Class III malocclusion treated with straight-wire appliance) Control group (patients with normal occlusion)	Labial alveolar bone thickness at apical level Lingual alveolar bone thickness at apical level	Labial alveolar bone thickness: 1.71 ± 0.43 mm Lingual alveolar bone thickness: -2.07 ± 0.51 mm
Articles	Teeth	Groups	Views	Results*
Thongudomporn et al.³⁴, 2015	Maxillary incisors	Test group (patients with mild skeletal Class III and straight-wire appliances)	Buccal and palatal sides at 3 mm, 6 mm and 9 mm from cemento-enamel junction	Labial alveolar thickness: 3 mm: -0.12 ± 0.18 mm / 6 mm: -0.18 ± 0.31 mm / 9 mm: -0.01 ± 0.63 mm Palatal alveolar thickness: 3 mm: -0.13 ± 0.24 mm / 6 mm: -0.34 ± 0.30 mm / 9 mm: -0.59 ± 0.48 mm
Uribe et al.³⁵, 2013	Maxillary central incisors Maxillary canines	Test group (patients with unilaterally or bilaterally congenitally missing maxillary lateral incisors)	Alveolar bone width measurements at 2, 4, 6, 8, and 10 mm apical to the alveolar crest	Central incisor: 2 mm: -0.45 ± 0.55 mm / 4 mm: -0.55 ± 0.76 mm / 6 mm: -0.88 ± 1.13 mm 8 mm: -1.35 ± 1.22 mm / 10 mm: -1.29 ± 1.64 mm Canine: 2 mm: -0.80 ± 1.17 mm / 4 mm: -0.67 ± 1.12 mm / 6 mm: -0.29 ± 1.27 mm 8 mm: -0.01 ± 1.43 mm / 10 mm: -0.07 ± 1.59 mm
Yodthong et al.³⁶, 2013	Maxillary incisors	Test group (patients receiving orthodontic treatment with upper incisors bound to retraction with a space >4 mm between lateral incisors and canines	Labial alveolar thickness and palatal alveolar thickness at crestal, midroot and apical levels.	Labial thickness at crestal level: -0.4 ± 0.3 mm Palatal thickness at crestal level: 0.20 ± 0.36 mm Labial thickness at midroot level: -0.2 ± 0.3 mm Palatal thickness at midroot level: -0.1 ± 0.60 mm Labial thickness at apical level: 0 ± 0.3 mm Palatal thickness at apical level: -0.6 ± 1.41 mm

* Difference between pretreatment and post treatment values as regards alveolar bone thickness. Negative values indicate a reduction in bone width; ML: midsagittal plane; RM 5mm apart from ML to the right; RD 10 mm apart from ML to the right; LM 5mm apart from ML to the left; LD 10mm apart from ML to the left.

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Effect of orthodontic treatment on alveolar bone thickness in adults: a systematic review

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[1] Contact address:
Michelle Sendyk Universidade de São Paulo, Departamento de Ortodontia Av. Professor Lineu Prestes, 2227, Cidade Universitária E-mail: msendyk@usp.br- São Paulo/SP - CEP: 05.508-000 - Brazil